Complications and Economic Burden of Surgery in Chronic Rhinosinusitis With Nasal Polyps: An Observational Cohort Study Using Swedish Register Data.

INTRODUCTION

There is a lack of comprehensive data on complications following sinus surgery (SS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to estimate the prevalence of SS-related complications in CRSwNP patients and examine patient characteristics, predictors of revision surgery, healthcare use, and associated costs using secondary care data from Swedish registers.

METHODS

This observational cohort study used Swedish administrative register data to report patient characteristics and estimate the prevalence and incidence of SS-related complications among CRSwNP patients. Healthcare resource use (HCRU) and associated costs, the probability of and predictors for revision surgery were assessed.

RESULTS

Out of 9178 CRSwNP patients who underwent SS, 8.5% experienced complications to SS. Asthma was the most frequently observed comorbidity. The probability of revision surgery within 4 years was 12%. Factors such as younger age at index, complications to first surgery, earlier index year, and comorbid asthma were significant predictors for future surgery. Within 4 years of follow-up, patients undergoing SS showed more HCRU and higher related costs compared to matched general population controls (€13 865 vs. €7088 per person; p < 0.001). Asthma comorbidity, the occurrence of complications, and undergone revision surgery were associated with higher costs.

CONCLUSION

Overall, this study provides valuable clinical insights into patient characteristics, complications to SS, resource use, and factors related to revision surgery in patients with CRSwNP.